You are on page 1of 5

e

sj Zr+c
€ o- urerffi (F. t. R.) uere'I"Isflj
sT" Eo qT{ do- ( 'l 3) (t" V" qo A1 Ejrrr 1s4 * s{efl-{)

1.' "fft{rt-S.
20,
ll
.j
i

Si-.:.-..o*. -)*:... .. -* .?..i.:.:v,*r*tn". +!ry lh* I sJn elz z- i


{P.s.) (Yr.) (F.l.R.!ol , (Date) A
c *qnr( (Secti ons).... L:t
H.. ?.. -+3... ... ?lfrr*. iS- |

(il) *emr( (sections) A


(Act).
Cl

(ril) (Act).
ry X >

{tv) srferF.rqqqi eIRTq s{4} $rE- f-+.l* S?rjrr s f,+r,, -


?r,16.
*errfisrq1 a
3. (E) Y
_x_
',41
of offefrce) (Day) (Datefrom) \ (Dateto)
( HT LLo.lE.q$f trSrcr' i;.
,
N
(Time pe\iod) (TimeFrom) {Timeto)
(€) umrtvrwg+<rfrflrr I
I
0 t$ t-L- L31 +s cr$I- v
\
(r) qrEFrEfrdq.GE1f"tu . l:;.-.1 I z- o 2_2- aq
r"EJ {-s-,gff
4q'd,-r
l--.J , I J fi? L"
I

4. vr.fitqTqs'R(Tvpeofrnformation) W
al r. @/*fra-{(written/orar)
s. Er.{rr{n-(6) qHrtfflrqsEs ...:F1f?-'I k'r';'
2- t-ife'-tta,.}* '(.i'

a-, f' ,/(


nxrf
l :f,{:i: l-:: } ll_ Jr'l:Il:"rT- '.=;.-1......'
1
r-
F
(''T ) qmr a1 ifrqr t 6n6{ d} q1q{n { qmr qr qrq
B
5. c'ft-dlfrr'ET{r(rf,r, l*
(6 ) Tq... {]o c$- ftr arg{rrr-fffl- L*

(u) firarrqhqrrEl........... :'l" J'r...,-l:-.


r:'',r.--. i Yj W
v/
(r)
t-
f?F) qrq* do.................A.....................trh ftnE .".............................Fr{tT
t{, /l o-..-......,.. thl
(q) tvn "
t r4;qf Ln
(tr) u;IT
o:ii 'r:'r *
i'-Tl1trn - sJ-?i..il'.:]
[e / IF
3n.l*...::
"fr q. r]T* |
:].1::i_:. ..'?-{,,';"
ail';
'i')l'- 'r r.l,l ,/q'
,
tr
r {/q
J\* tww
F .L L'1 qrw *rb,
1r I r,/ 8rs7t Ji/4'/ <v
\ ,'-7=E:-x,-a* A** . (a- r
L-
(2)
,Kq.r slT{ai 47,WE[{io-118
7 . Ilrar+iF+erzerfla eTFrgffi qr f+qrur ( qR qmrqffi dd ere.r t rrqr Frrnq ) g

...,/l*r:..::.r,...*.. i:r..

{ferq qk ;fr vnfrks ffiqnn( , fqwqfrr asn erq t+errr - :

"fu{
\-jqfdfE
falqrcrs€{ ffiR-* rrerq
ff*.
rfro H "q-fqrr tq-6
( ) fr (ldentification
(Sex) Date of Birth (Build) (Height) (Complexion)
mark)
(Date/Month/Year) (in Cms)
,1
2 3 + 5 6

tfirqrrtzflffigrsrfll *qtrg *s{refr


(Deformities/
krd 6{te1
"r6{rqr
peculiarities) (Teeth) (Hair) (Eve) (Habits) (Dress Habits)

i, 7 8 I 10 11 12

I
:.!

1a
3
I
3

E *qrqtuffi TSTr;I

r (Language/ Vd qr f{$rn t+d EEa faa *sq frr6 thfir


Dialect) (Burn Mark) (Leucoderma) (Mole) (Scar) (Tattoo)
a

t 13 14 15 16 17 18

1 i;J'' rs$ 'f,1."'"'"


*{"-w,+
r*$,, I
(

?Tf( ffi,,sftrmr ii qre/fi&fr e,ffi EriT if el$ q* qT srfgrfi fsfM {.ilrq asfr Eq
€ii,rq a{Fffi * rfafer
Oql q skkqf e1wgfr I Esm'r B,rfrq argeunm * rercrmd *-+m uffnrm {qrt * w\ilT t fr fqqr qrq.n r

?H vms .rq snisq er( t t6.T fr dftrq qFm e} fdi{r l11"df , qR et$ d, t *tm

. , Etg ai|.$ "*


gfi{gtr frrmn fdnin qrq ird yS-fi{6 q{ &-rTR ?}; t*,q frqT qrfr qdi t faffera;qrq-fi silr Tot gTH Er:
r

tffitu'qlrqrt r
A
s-
,+

tt fl L

r
@
0
p
,L
p
La a

t3 + l-'
a
-6
lc
rj d
t'
-tr \)
ts
4 I-
?

r
c)

C)
I
L
f
jI.
.}P o=
5,
E)
.[" P
I

(
lr"
fi
+
r,
t$
-lj
f t\

t
VU

td
-s
$
a 6
\4 ,& ()6
Lt
r{]
G
a

E
1
g.rryr*
.-,- --q -'T+:

$
I

,.'.,il
'' :_\,
,' ..:.a
]
'

*l::
' "'
t - --,-:|'

{
{q
i

;.\
1
i-1..
s
",. '',
-:_
b{qr Nt
.x-

i
{
i

J
l

\
s,

$ ::
it
,ii

i
ri
I
_1

-l .

,i
,*
,Y
1

$\ '

S'r
\l {{
i

-l tr
P'\ .. i

:j
:4.
.i,
r*
't

'.ffr .jl

I
t
q sDHE)ar VW6fu
fi
fi*

06 g#qvvrfuuffi-w- \ .,r'J
lt

You might also like